Because of the epidemic, the Geneva University Hospitals (HUG) are reorganizing to gain beds and reassign staff to take care of Covid-19 patients. Non-emergency surgeries have been discontinued, non-Covid patients have been transferred to clinics, the main hospital building is now dedicated exclusively to patients with the virus, and staff are being reassigned for critical care, among others.
Maternity also undergoes major changes: collaboration for certain deliveries with private clinics, acceleration of return home or even necessary screening of spouses to assist in childbirth (see opposite).
The scheduled in the clinic
The HUG Maternity Hospital, the largest in Switzerland, saw the birth of 357 babies in the last month – including triplets last Thursday, an event that only happens once or twice a year. Despite the epidemic, life therefore continues its course. But in a unique setting and conditions.
First, the HUG decided to decrease the activity at the Maternity. Thus, the follow-up of low-risk pregnancies is done by the treating gynecologists until the term and the planned caesareans, also at low risk, take place in private clinics (Les Grangettes, La Tour and Clinique Générale-Beaulieu). What is a priority and urgent remains at Maternity, that is, the planned cesareans at risk of complications as well as the follow-up and delivery of high-risk pregnancies (involving diabetes and other pathologies, premature, twin, requiring interpreters, etc.). The vaginal deliveries are also maintained there.
Why not delegate more to clinics? Begoña Martinez De Tejada Weber, chief doctor of the obstetrics department, explains that these do not have the same capacity of delivery rooms or personnel as the Maternity. “It makes it difficult to accommodate unscheduled deliveries. As for pregnancies at risk, some require a specific technical platform, specific skills and a 24-hour team. We are decreasing our activity, but it will remain important! ”
Indeed, the share of birth delegated to clinics is currently quite low. “At HUG, we assist 10 to 14 deliveries a day,” explains the head doctor. Last week, some four of our caesareans were transferred to the clinic. There will be more in the coming weeks because the collaboration is very good. The volume offloaded at the clinics may seem low, but it’s already a big help. ” Because these less patients, coupled with the elimination of non-emergency operations, will free gynecologists, doctors and nurse anesthetists. “These will come in support of the treatment of Covid-19 patients,” reports Nicolas de Saussure, spokesperson for the HUG. Equipment may also be made available. ”
Faster exit followed
Another measure to free up staff: rapid return home will be applied for healthy mothers and babies. Or an exit within 24 to 48 hours, against three to four days currently for vaginal delivery without complications. Begoña Martinez De Tejada Weber notes that this is already the practice in other cantons, “with us postpartum supervision is very extensive and continues outside of maternity. “People who don’t need hospital care can go home, you have to reserve the hospital for those who need it, without looking at the length of stay.” In any case, she adds, “since visits are now prohibited (see opposite), mothers ask themselves to come home faster.”
The accelerated return is however accompanied by a parachute: reinforced home monitoring thanks to the action of the Arcade midwives and independent midwives. These will occur daily, if the mother wishes, for at least four days. “In addition, the pediatrician will also be on the move to examine the newborn. Finally, the gynecologist treating the patient and our team are always on hand if there are any questions. ”
In addition to these reorganizations, Maternity has set up a Covid-19 unit where women positive for the virus are grouped, reports Nicolas de Saussure. This unit has fourteen beds. Eleven pregnant women were positive, four of whom gave birth.
Created: 02.04.2020, 06:33
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